As If Birthing the Baby Wasn't Enough...

Some women may not know that about 1% of the time when an epidural is put into place, it causes a severe headache. This headache feels much like a migraine and is quite debilitating. Understanding why an epidural headache occurs and how to cope with it can help you to make your decision about whether or not to have an epidural, and it can help you to know how to deal with the situation, should it arise.

Why Does an Epidural Headache Occur?

If the epidural needle is pushed just a bit too far during the procedure, it can pierce the membrane, or dura, which forms the spinal sac. There is spinal fluid in this sac, and the puncture can cause a small leak of fluid into the epidural space. This fluid leak is what causes a low pressure headache. The low pressure around the brain and spinal cord cause the headache, and also explain why it is less severe when you are lying down then when you are sitting up.

More Details about an Epidural Headache

This headache is usually felt in the front or back of the head and neck. It will get worse if you are sitting or standing. Usually, it will develop within 18 hours of the epidural and will last for 4-5 days. When you no longer have the headache, this indicates that the body has created a seal over the puncture and that the fluid is no longer leaking. While at times the headache is not hard to live with, at other times it can seriously impair the woman’s ability to function during those days and to nurse and care for the baby.

More Prone if you get Migraines?

One question that women will often ask is if they are more prone to getting an epidural headache if they have a history of migraine headaches. The answer, unfortunately, is “yes”. Since migraine headaches are partly due to the dilation of the blood vessels of the brain, and epidural headaches are due to a similar response to low pressure in the brain, someone with a history of migraines might be more likely to get an epidural headache. This is not to say, however, that someone with a history of migraines should avoid epidural anesthesia or that they will definitely develop a headache from the epidural.

How To Help Yourself

If you do develop an epidural or spinal headache, there are treatments that can help. Certainly, you’ll want to have plenty of bed rest and not walk around or sit up too much. Some say that you should drink fluids, which include caffeine. However, no research has definitely shown that fluids help to relieve this headache, and they make you get up to go to the bathroom often. You can try regular headache medicines and can ask your doctor to prescribe other medication such as paracetamol which might help. Should these solutions fail, there is an effective treatment, an epidural blood patch (EBP), also known as the “blood patch” that will usually work. This is an easy procedure where your own blood is taken from your arm and injected into the epidural space to “patch up” the hole. In over 80% of cases, this completely resolves the headache within a few hours. For those for whom it doesn’t work, doing the procedure again is found to be 95% effective in resolving the rest of the headache cases.

Get all of the facts about epidural headaches so that you can make an educated decision for yourself – and so that you’ll know why you have a headache, should this situation occur for you.